Case Overview (Image-Based Observation – 100% Zoom)

At full zoom, the image shows an open tooth socket between two adjacent teeth with dark gray–green necrotic material, inflamed surrounding gingiva, and exposed socket walls. The gum tissue appears red, swollen, and irregular, with signs of delayed or failed clot formation.

 The patient reports the tooth “really smells worse”, which is a critical diagnostic clue.

Primary Clinical Impression

 Dry Socket (Alveolar Osteitis) with Secondary Infection
(Highly consistent with findings from Europe PMC source)

Color & Tissue Analysis (Detailed)

Socket Area

• Gray-green discoloration → necrotic tissue + bacterial biofilm

• Dark brown/black spots → decomposed blood remnants

• White-yellow film → bacterial exudate / fibrin breakdown

• No healthy red blood clot visible

Gum Tissue

• Bright red margins → acute inflammation

• Shiny surface → edema

• Uneven healing edges → tissue breakdown

Adjacent Teeth

• Old restorations present

• Increased plaque retention zones

• Potential bacterial spillover into socket

Diagnosis (Expanded & Evidence-Based)

Primary Diagnosis

Infected Dry Socket (Alveolar Osteitis with Putrefaction)

Supporting Signs

• Exposed socket

• Necrotic debris

• Severe halitosis (bad smell)

• Inflammation persisting beyond normal extraction timeline

 Clinical source expansion (Europe PMC – PMC5932271):

• Dry socket occurs when the blood clot dissolves or is lost

• Bacteria colonize exposed bone

• Tissue necrosis produces volatile sulfur compounds → foul odor

• Healing is delayed without intervention

Why the Smell Is Extremely Bad (Deep Analysis)

The odor comes from:

• Anaerobic bacteria breaking down dead tissue

• Production of:

  • Hydrogen sulfide

  • Putrescine

  • Cadaverine

 This smell is not normal healing and indicates active infection

Biological Progression (What’s Happening Inside)

1. Tooth extracted

2. Blood clot fails or dissolves

3. Bone exposed

4. Anaerobic bacteria colonize socket

5. Tissue necrosis begins

6. Infection spreads locally

7. Pain, odor, inflammation escalate

Healing Time Frame (With Proper Treatment)

Day 0–2 (After Intervention)

• Odor reduces significantly

• Pain becomes manageable

• Socket cleaned and medicated

Day 3–7

• Granulation tissue begins forming

• Gum inflammation decreases

• Smell nearly gone

Day 8–14

• Socket closes progressively

• Healthy pink tissue replaces necrosis

• Normal healing resumes

 14 days is realistic ONLY with professional treatment

 Without treatment, healing may never occur properly

Treatment Process to Execute (Critical)

Immediate Dental Intervention

• Thorough socket irrigation

• Removal of necrotic debris

• Medicated dressing (eugenol / antimicrobial)

• Pain management

• Possible antibiotics (case-dependent)

At-Home Care (Adjunct Only)

• Warm saline rinses (gentle)

• Avoid suction, smoking, spitting

• Maintain oral hygiene without disturbing socket

• Follow dentist’s dressing schedule

 Do NOT self-medicate or scrape the socket

If Untreated: What Will Scale Up (Serious Risks)

 Infection progression may lead to:

• Spreading abscess

• Osteomyelitis (bone infection)

• Facial cellulitis

• Fever and systemic infection

• Damage to adjacent teeth

• Chronic non-healing socket

• Hospital-level intervention

 The smell worsening is a sign of rapid bacterial escalation

Professional Comments

• This is not normal post-extraction healing

• Foul odor + necrosis = urgent dental condition

• Early treatment drastically shortens healing time

• Delayed care increases cost, pain, and complications

Next Step: Visit a Dental Clinic Immediately

Do not wait for symptoms to improve on their own.

 Find a nearby dental clinic now:
 https://cebudentalimplants.com/map-dental-clinic